The importance of self-observation of fecal blood in indicating a proper bowel examination.

This study presents a new model of screening for colorectal cancer. Persons aged 50 or over in a city of 160,000 inhabitants were encouraged by a newspaper campaign to act on signs of fecal blood and to come forward for examination. A quantitative immunological human hemoglobin (Hb)-specific test method was employed, and, as a simple discriminatory help to minimize perianal contamination, a constringent local ointment was used. The group of fecal bleeders was examined by colonoscopy. Altogether, 1638 persons came forward to request screening. Of these, 168 were submitted for colonoscopy, and, among those 18 colorectal cancers (11% of colonoscopies) were found. Of the cancers a significant part 28% were early cases (Dukes' A). In addition 28 adenomas were detected. The results show that there exists in the population a group of neglected fecal bleeders. Increasing the population's awareness of this symptom as a possible sign of colorectal cancer combined with prompt and proper medical investigations would lead to the detection of early cases of colorectal cancers.